SHIELD Agency Counseling Center
by EmeraldChick
Summary: Set at the end of Avengers, Director Fury has ordered all of the original members to report to a counselor in order to receive Assesments in order to return to the field.
1. Tony

**REPORT OF PSYCHOLOGICAL ASSESSMENT**

 _Confidential Material_

NAME: Anthony Edward Stark

ALIAS: Tony; Iron Man

DATE OF BIRTH: May 29, 1970

AGE: 47

MARITAL STATUS: Single

SEX: Male

OCCUPATION: Inventor

SPECIES: Human

 **IDENTIFYING DATA AND REASON FOR REFERRAL  
**  
Tony is a 47 year old Caucasian male, who was referred for a psychological evaluation to determine his current behavioral, cognitive, and emotional status. Tony has a long history of alcoholism and impulsive behavior. He is the superhero Iron Man, a member of The Avengers, and the head of the Research and Design Department of STARK contributing factors include poor impulse control, conflicting sense of duty between the United Nations and the Avengers, and turbulent upbringing.

 **SOURCES OF INFORMATION**

Background information was obtained from his girlfriend, Virginia "Pepper" Potts, his military contact, Lt. James Rhodes, his United Nations Contact, Gen. Ross, and his Head of Security, Happy Hogan, along with scarce educational and medical reports. This information was obtained from interview, developmental history and rating scales as well as medical records. This information appears to be from reliable sources and valid. 

Current status of his cognizant and emotional behavior was obtained from observation during testing and from standardized psychological, neuropsychological and achievement tests. The validity of his performance on most tests was deemed to be accurate due to his cooperation and motivation to perform the tests. 

**BACKGROUND INFORMATION**

 _Current Concern_

Tony played a contributing role in the proposed Sakovia Accords, during which the avengers split. Since then, Tony has been assisting the United Nations with the Accords fallout, and mentoring Spider-Man. However, the fracturing of the team has taken its toll on Tony. This assessment is to determine his current mental state, and whether he should lead the Avengers.

 _Medical and Developmental History_

 **Pregnancy and Birth:** Howard was 53 when Tony was born, and there has been no reported problems through the delivery.

 **Developmental History:** Tony was smaller than average growing up, but showed his father uncanny high intellect. As a child, he spent most of his time with his mother or his butler, Edwin Jarvis, due to his father's work. When he was old enough to go to school, he was sent to boarding school, and only saw his parents during breaks. He ended up forming stronger bonds with Mr. Edwin Jarvis, the family butler, and Obadiah Stane, who was his father's business partner. He went to college early, at the age of 15, attending MIT and earned several master degrees. When he was 21, his parents died, and Obadiah Stane mentored him.

 **Medical History:** Tony did not show any chronic illness throughout childhood, and he only suffered from the usual childhood illness. In college, he began developing an alcohol addiction that worsened after the death of his parents.

In early 2008, Tony went to Afghanistan for a weapons demonstration. He got captured after catching shrapnel in the heart. After an operation, Tony had a magnet implanted into his chest, a miniature arc reactor. He then used the reactor to power his first Iron Man suit, and escaped captivity.

Tony used the suit to protect him in multiple battles, and the use began to give him incurable blood poisoning. Thinking he was going to die, Tony increased his alcohol use, until he created an element that was a suitable palladium replacement. Implanting the new core cured him of any blood poisoning, and he began to abstain from alcohol. Later, he survived several assassination attempts from Whiplash and the Mandarin, both now deceased. He got several minor injuries during many missions including New York, Sokovia, and Washington DC.

 _Family and Social History:  
_ Howard Stark had a reported alcohol dependency, and Maria Stark suffered from depression. Currently, Tony lives with his girlfriend, Pepper Potts. Try has a few close friends including James Rhodes, who befriended Tony at MIT, Happy Hogan, the STARK INDUSTRY head of security, and Bruce Banner, a consultant for the Avengers. Tony has been friends with Steve Rogers, Natasha Romanov, and Clint Barton, but they currently have an estranged friendship due to the fallout of the Accords. He is close to Agents Coulson and Fury, but both are presumed dead. Currently he is mentoring an unidentified inspiring hero, Spider-Man.

 _Summary of Previous Evaluations:_

Tony has refused multiple attempts of assessment, but he was assessed by Natasha Romanov, a government agent. She stated that he displayed compulsion behavior, self-destructive tendencies, and textbook narcissism. How we, she was assessing for field recruitment purpose and not for psychological purpose.

 **BEHAVIOR OBSERVATIONS**

 _Testing Behavior_

When he first got to the session, Tony displayed an air of superiority, and denied any need of assessment. However, throughout the session, Tony discussed many people reason why he was here, which was to make it up to many people in his life. He said that he regretted his actions, like the Sokovia Accords, and wanted to understand the root of those action. Also, he discussed his new protégé Spiderman stating that he wanted to be the best mentor he could, and that included getting help with needed. Afterwards the client discussed multiple situations and performed all test with enthusiasm.

 _Psychological Assessment_

The clinical interview for Tony took place over two days. On the first day, the Assessment of Intellectual Functioning (IQ) and the clinical interview took place. A week later, the client returned for the Personality Assessment and Behavioral Assessment. After the results were computed, the client was debriefed.

TESTS ADMINISTERED

Standardized assessments targeted the domains of intelligence, personality, and psychological health.

Assessment of Intellectual Functioning (IQ)

Beck Anxiety Inventory- Personal Care (BAI-PC)

Myers Briggs Personality Test

Wechsler Adult Inventory Scale- Fourth Edition (WAIS-IV)

INFORMATION ASSESSMENT TECHNIQUE

Interviews

Primary Sources Index

Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition

Diagnostic Checklist for PTSD

 **RESULTS FROM TESTING**

Using information from multiple sources, the following domains of functioning were analyzed in terms of the effect on Tony's cognizant and emotional assessment.

 _Assessment of Intellectual Functioning (IQ)_ : The IQ using the WAIS-IV with four index scores Verbal Comprehension, Perceptual Reasoning, Working Memory, and Processing Speed. The combination of the scores is used to determine his intelligence functioning score at 123, placing him in the Superior IQ classification.

 _Clinical Interview:_ The clinical interview was a face to face interview conducted in the office. Results indicated that Tony is a very intelligent man, but he is also egotistical. He became Iron Man when he got captured in Afghanistan for three months, and he saw all his weapons in the hands of terrorist. He says being Iron Man allows him to make up for a lot of people who got killed. Also, he said that he wanted to try and take more steps minimizing casualties, which was his reasoning for creating Ultron. When his girlfriend wanted him to choose her over being Iron Man, they broke up. He says that he is having nightmares, and occasional chest pains. His doctor found no physical reasoning and it sounds like it is a signing the Soviet Accords.

PTSD

A1. Directly experience traumatic event

B5: Marked physiological reactions to internal use

C1: Avoidance or efforts to avoid distressing memories, thoughts, or feelings

D2: Persistent and exaggerated negative beliefs about oneself, others, or the world

D4: Persistent negative emotional state

E2: Reckless or Self-destructive behavior

E3: Hypervigilance

E5: Problems with concentration

E6: Sleep Disturbance

F: Happens for at least one month

G: clinically significant distress or impairment

H: Not attributable to the effects of substances

Summary

Tony is a 47 year old Caucasian male who was referred for neuropsychological assessment to determine his behavioral, cognizant, and emotional status, and to make recommendations regarding a treatment plan. He has experienced difficulty with trusting teammates and is experiencing trauma. There is concern that he may also have symptoms of post traumatic stress disorder. An evaluation of his early development, cognitive capability, emotional status and academic achievement resulted in a determination of a complex set of characteristics that are contribution to his difficulties.

Tony performed at a superior range of cognitive functioning with notable distinction in nonverbal functions. Excellent abstract cognitive capability was noted for abstract thinking in both verbal and nonverbal visual spatial modalities. These good capabilities are reflected by his outstanding ability with math reasoning and verbal comprehension. His oral language is also mature and demonstrates good verbal communication skills. His academic skills are all within the average or above level of ability.

He demonstrates some positive symptoms of an post traumatic stress disorder. Most likely the underlying anxiety and depression, as well as the identified learning disability contribute to these symptoms of panic attacks, trouble sleeping, heart palpitations, and avoidance. Any treatment must consider the interaction of these combined conditions.

 **RECOMMENDATIONS**

In order to best serve Tony's needs there are several areas that may be targeted for intervention.

Medication. With the diagnosis of Posttraumatic Stress Disorder, many clients respond to an antidepressant. An antidepressant many have responded to is Zoloft. Tony will start on the initial dosage 25mg. If he is responding the dosage will move to 50 mg next session. If it is needed dosage will continue to increase through doctor recommendations.

Psychotherapy. There are several types of psychotherapy that might help Tony start to recover. Cognitive Behavior Therapy is a Therapy that has shown a lot of progress on Post Traumatic Stress Disorder. It will include:

Exposure Therapy. Allowing Tony to face the trauma in a controlled environment.

Cognitive Restructuring. Allow Tony to dismiss feeling of unnecessary guilt.

. (2015, September 23). Zoloft: Uses, Dosage, Side Effects & Warnings. Retrieved August 09, 2017, from .

FANDOM Movies. (n.d.). Howard Stark. Retrieved August 08, 2017, from wiki/Howard_Stark

FANDOM Movies. (n.d.). Iron Man. Retrieved August 07, 2017, from  wiki/Iron_Man

Geekspodcast. (2016, May 05). The Psychology of Iron Man: Geek Deconstructed E10. Retrieved August 07, 2017, from  watch?v=ECUaKwxppds

Geek Psychology. (2017, February 17). What is Iron Man's True Personality? The Power of ENTP! Retrieved August 07, 2017, from  watch?v=fFLdg9ERXR4

Hotfireend. (2011, June 25). Iron Man 2 Ending. Retrieved August 08, 2017, from  watch?v=sbM9Gaan-XY

IQ classification. (2017, August 08). Retrieved August 08, 2017, from  en. wiki/IQ_classification

MARVEL. (n.d.). Iron Man (Anthony Stark) - Marvel Universe Wiki: The definitive online source for Marvel super hero bios. Retrieved August 08, 2017, from  /universe/Iron_Man_(Anthony_Stark)#axzz4pCSTIYwv

NERIS Analytics Limited. (2011). ENTP Personality ("The Debater"). Retrieved August 07, 2017, from  www. /entp-personality

National Institute of Mental Health (NIMH. (2016, February). Post-Traumatic Stress Disorder. Retrieved August 07, 2017, from  . 

US Department of Veteran Affairs. (2007, January 01). PTSD: National Center for PTSD. Retrieved August 07, 2017, from  . 

U.S. Department of Veterans Affairs. (2007, July 05). PTSD: National Center for PTSD. Retrieved August 08, 2017, from  . 

Wechsler Adult Intelligence Scale. (2017, June 07). Retrieved August 08, 2017, from en. wiki/Wechsler_Adult_Intelligence_Scale#/search


	2. Bruce

**REPORT OF PSYCHOLOGICAL ASSESSMENT  
** _Confidential Material  
_

NAME: Robert Bruce Banner

ALIAS: The Hulk

DATE OF BIRTH: 12/18/1969

AGE: 47

MARITAL STATUS: Single

SEX: Male

OCCUPATION: Nuclear Physicist

PARENTS: Rebecca Banner & Brian Banner

 **IDENTIFYING DATA AND REASON FOR REFERRAL**

Bruce is a 47 year old Caucasian male, who was referred for a psychological evaluation to determine his current behavioral, cognitive, and emotional status. Bruce has a long history of rape control issues and depression. He is a published nuclear physicist, the superhero Hulk, and a member of The Avengers. He disappeared after the battle in Sokovia against Ultron, and has resettle requested renewed membership on the Avengers. Some contributing factors include rage control issues, loss of a loved one, and turbulent upbringing. 

**SOURCES OF INFORMATION**

Background information was obtained from Strategic Homeland Intervention, Enforcement and Logistics Division (SHIELD), US Army records, former psychologist, and previous psychological and medical reports. This information was obtained from interview, developmental history and rating scales. This information appears to be from reliable sources and valid.

Current status of his behavioral, cognitive, and emotional status was obtained from observation during testing and from standardized psychological, neuropsychological and achievement tests. The validity of his performance on most tests was deemed to be accurate due to his cooperation and motivation to perform the tests.

 **BACKGROUND INFORMATION:**

 _Current Concert:_

Bruce has long struggled with his anger, which stems from his childhood. However, his relationship with his teammates is solid, they all report trusting Bruce and Hulk. His ability to control the Hulk remains a concern, but he has displayed control on the battlefield numerous times. During a field assignment, Bruce stated he was suicidal in the past. The most pressing concern at this time is his anger and his depression.

 _Medical and Development History:_

Pregnancy and birth history: since both of his parents were deceased, Bruce supplied the information. His parents were both young, in their early 30's when they had Bruce. There was no complication during his pregnancy or birth.

Developmental history: Bruce did not know his father growing up, and lived with his mother. He showed above average intelligence at a young age, however he had a slightly smaller build than others at his age. Developmental milestones were reported as within normal range for language, gross motor, and fine motor development. He had numerous accidents as a child including with bruises and broken bones. These were from his father, according to Bruce.

Medical history: Growing up, had the usual childhood illnesses of chicken pox, ear infections and strep throat. In 2005, he was in a laboratory accident which exposed him to deadly amounts of gamma ray exposure. However, he survived due to the Hulk, an indestructible, muscular, green-skinned titan.

 _Family and Social History_ :

Dr. Brian Banner, deceased, was an atomic physicist, however at home he was an abusive alcoholic. Rebecca Banner, deceased, is Bruce's biological mother, who suffered from depression. After his mother's death, his father was convicted of murder and placed in a psychiatric institution. Bruce was placed in foster care.

Before he became the Hulk, Bruce pursued a romantic relationship with Betty Ross, who he met at college. Together they worked on a bio-tech research project replicating Project Rebirth, the project that created Captain America. Under the stress of deadline, Bruce tested the project on himself, resulting in the Hulk. Bruce and Betty continued their relationship, but General Ross hunted Bruce, who went into hiding. The unrelenting pursuit of General Ross resulted in the termination of their relationship. Under direction of Agent Coulson, Agent Romanov located Bruce and persuaded him to join the Avengers Initiative. They are currently attempting to pursue a romantic relationship, but the fallout of the Battle of Sokovia has kept them separated.

 _Summary of Previous Evaluations_

Bruce went to multiple sessions as a minor as result of his mother's death while in foster care. The sessions indicate that he has problems with anger management that occasionally disrupted his school and home life. He was taught several anger management techniques and has had the most success with meditation. However, since he got out of foster care system, Bruce has refused any psychiatric consultation, reasoning the sessions will not change the past. During the Battle of New York, Bruce stated adamantly he could not be killed, "because he tried." Since then, he claimed that several teammates, namely Tony, Natasha, and later Sam Wilson, had discussed with him a safety plan, see below.

 **Behavior Observations**

 _Testing Behavior_

Bruce is a middle aged, mild mannered gentlemen. He took part of all tests willingly and eagerly, claiming that he wanted to "prove he was not a monster." However, during the interview, only referred to the Hulk as "the other guy." Also, he did not want to discuss his parents, only stating that his mother "was an angel", and "he (the Hulk) doesn't like Brian," with a sheepish grin. The subject was dropped.

 _Psychological Assessment_

The clinical interviews for Bruce took place over two days. On the first day, the Assessment of Intellectual Functioning (IQ) and the clinical interview took place. A week later, he returned and the Personality Assessment and the Behavioral Assessment took place. After the test were complete, the client was debriefed.

TESTS ADMINISTERED

Standardized assessment targeted the domains of intelligence, learning processes, academic achievement and emotional/psychological development. 

STANDARDIZED INSTRUMENTS:  
Wechsler Adult Intelligence Scale-Fourth Edition(WAIS-IV)

Cognitive Assessment System  
Wechsler Individual Achievement Test  
Myers Briggs Personality Assessment

INFORMATION ASSESSMENT TECHNIQUES:

Development History Form  
Interviews  
Primary Sources Inventory  
Diagnostic Checklist for DID symptoms

Behavior Observations  
Review of medical reports

 **RESULTS FROM TESTING**

Using information from multiple sources, the following domains of functioning were analyzed in terms of the effect on Bruce's cognizant and emotional assessment.

 _Assessment of Intellectual Functioning:_ The IQ was scored using WAIS-IV with the four index scores Verbal Comprehension, Perceptual Reasoning, Working Memory, and Processing Speed. The combination of the scores was used to determine his intelligence functioning score at 112, placing him in the Superiority intelligence category.

 _Clinical Interview._ The clinical interview was a face to face interview conducted in the office. Results indicated that Bruce was a very intelligent man, who cared deeply about people. Although he is a nuclear physicist, Bruce Banner has also undergone some medical training. He enjoys medicine claiming that it helps him "make up for the horrors" he had done.

When discussing if he sees the good that he had done as helping the Hulk with the Avengers, Bruce stated that many on the team seem "the other guy" as a powerful ally with a big temper. According to Bruce, the Hulk has name for all of the original Avengers. He is very protective of Iron Man and Agent Romanov because they are so kind to Hulk. He understands that Captain America gives the orders, and he usually listens. For the most part he ignores Agent Barton. He does not like Thor, but has learned to tolerate him. He does not really know a lot of the other strike teams, with the exception of Scarlet Witch. Hulk does not like her because she "hurt his head". The rest of the team, he does not really know and does not care one way or the other. Bruce says Hulk bases most of his opinions on people, including the Avengers, based on Banner's experience.

 _Clinical Diagnosis:_ Dissociative Identity Disorder (DID)

Bruce displays the following symptoms 10 of 16 symptoms Dissociative Identity Disorder:

Unexplained events and inability to be aware of them

Frequent bouts of memory loss

Sudden return of memories, as in a flashback and/or flashback to traumatic events

Episodes of feeling disconnected or detached from one's body and thoughts

Suicide attempts

Changing levels of functioning, from highly effective to nearly disabled

Depression

Nervousness

Headaches

Sexual dysfunction

 **SUMMARY**

Bruce is a 47 year old Caucasian male who was referred for neuropsychological assessment to determine his mental and emotional status and to make recommendations regarding a treatment plan. He has experienced difficulty with controlling his alter ego, the Hulk. There is concern that he may also have symptoms of Dissociative Identity Disorder. An evaluation of his early development, cognitive capability, emotional status and mental status resulted in a determination of a complex set of characteristics that are contribution to his difficulties. 

Bruce performed at an Superiority range of cognitive functioning with no notable differences between verbal and nonverbal functions. Excellent abstract cognitive capability was noted for abstract thinking in both verbal and nonverbal visual spatial modalities. These good capabilities are reflected by his outstanding ability with math reasoning and verbal comprehension. His oral language is also mature and demonstrates good verbal communication skills. His academic skills are all within the average or above level of ability.

He demonstrates some positive symptoms of an dissociative identity disorder. Most likely the underlying depression and has experience past abuse. He is experiencing multiple symptoms including of panic attacks, trouble sleeping, heart palpitations, and avoidance. Any treatment must consider the interaction of these combined conditions.

 **RECOMMENDATIONS:  
** In order to best serve Bruce's needs there are several areas that may be targeted for intervention:

Psychotherapy. Individual psychotherapy should be the primary would be instrumental in discovering the patterns of Bruce's anger. The goal of therapy will be to integrate Bruce and Hulk, which allow Bruce to control Hulk's actions. Given recent mission can find different grounding techniques and to combine

Group Therapy. One factor of Banners depression is the concept of shame that only the Hulk could be that cruel, and that the Hulk is a monster. Group therapy, particularly one that is domestic abuse survivors, or one which consists people who experience DID, will allow for some of the shame or depression to dissipate.

Medications

Chlordiazepoxide. This is a medication that has been very effective in treating anxiety. been used to treat anxiety. This would allow for Bruce to choose when to turn into the Hulk as a defense system, protecting himself, the Avengers, or civilians during attacks, instead of the Hulk coming out to fight against Bruce's wishes. Common side effect are Clumsiness; confusion; dizziness; excessive daytime drowsiness; headache; lack of coordination; lightheadedness; unsteadiness; unusual weakness.

Zoloft. This is an anti depression medication that has been very effective. Bruce will start on the initial dosage 25mg. If he is responding the dosage will move to 50 mg next session. If it is needed dosage will continue to increase through doctor recommendations.

Clinical Hypnosis. Hypnosis can assist client in retrieving repressed memories and continuing to fuse Bruce and the Hulk, brought on by DID in a safe environment.

American Association for Marriage and Family Therapy. (2017). Dissociative Identity Disorder. Retrieved August 10, 2017, from  iMIS15/AAMFT/Content/consumer_updates/Dissociative_identity_

. (2015, September 23). Zoloft: Uses, Dosage, Side Effects & Warnings. Retrieved August 09, 2017, from .

. (2017). Chlordiazepoxide: Indications, Side Effects, Warnings. Retrieved August 10, 2017, from  . 

Indiana University. (n.d.). REPORT OF PSYCHOLOGICAL ASSESSMENT. Retrieved August 10, 2017, from  .edu/~k305to/roles/articles/psy_ 

IQ classification. (2017, August 08). Retrieved August 10, 2017, from en. wiki/IQ_classification

MARVEL. (n.d.). Hulk (Bruce Banner) - Marvel Universe Wiki: The definitive online source for Marvel super hero bios. Retrieved August 10, 2017, from /universe/Hulk_(Bruce_Banner)#axzz4pJKypnuK 

Marvel Cinematic Universe . (2010, November 3). Betty Ross. Retrieved August 10, 2017, from  wiki/Betty_Ross

Marvel Cinematic Universe Wiki. (2017, March 17). Hulk. Retrieved August 10, 2017, from  wiki/Hulk

National Institute of Mental Health (NIMH). (2016, April). Bipolar Disorder. Retrieved August 10, 2017, from  . 

Tracy, N. (2017, May 23). Dissociative Identity Disorder (DID) DSM-5 Criteria - Dissociative Identity Disorder - Abuse. Retrieved August 10, 2017, from  abuse/dissociative-identity-disorder/dissociative-identity-disorder-did-dsm-5-criteria/


	3. Natasha

**REPORT OF PSYCHOLOGICAL ASSESSMENT  
**

 _Confidential Material  
_

NAME: Natalia Romanov  
ALIAS: Natasha, Nat, Black Widow, Natalie Rushman,

DATE OF BIRTH: 11/22/1984

AGE: 32

MARITAL STATUS: Single

SEX: Female

OCCUPATION: Special Agent

PARENTS: Unknown

 **IDENTIFYING DATA AND REASON FOR REFERRAL:  
** Natalia is a 32 year old Caucasian female, who was referred for a psychological evaluation to determine her current behavioral, cognitive and emotional state. Natalia was formally an agent of KGB, but was discovered and flipped by Agent Barton. She resided with the Barton's for several months while recovering from KGB treatment. She became a SHIELD agent, and continued under the codename of Black Widow. During the Sokovia Accords, she went underground with Captain America's team. Currently, she is at an underground SHIELD facility, and has agreed to undergo this assessment.

 **SOURCES OF INFORMATION  
** Background information was obtained from her partner, Clint Barton,

her former handler, Nick Fury, and his United Nations Contact, Gen. Ross. This information was obtained from interview, developmental history and rating scales as well as medical records. This information appears to be from reliable sources and valid.

Current status of her cognizant and emotional behavior was obtained from observation during testing and from standardized psychological, neuropsychological and achievement tests. The validity of her performance on most tests was deemed to be accurate due to her cooperation and motivation to perform the tests.

 **BACKGROUND INFORMATION  
**  
 _Current Concern  
_  
Natalia is a highly-trained agent raised by the Black Widow program. When the avengers split, she sided with Tony, but secretly assisted Captain America. She returned to the compound with Captain America. However, Natalia feels guilt about betraying towards Tony Stark's team, due to their history. This assessment is to determine her current mental state, and assist in processing the events.

 _Medical and Developmental History_

 **Pregnancy and birth:** Natalia never knew her parents or her birthplace, however Sterns, a target she eliminated, placed her accent. According to Sterns, she was born in Stalingrad, currently called Volingard, the administrative center in an oblast in Russia.

 **Developmental history:** Natalia was raised in the Red Room, a Soviet training facility for female government agents during the Cold War. At the training facility, she was trained in hand to hand combat, acrobatics, weapons training, tactical skills, and ballet training. The program was designed to create a mindset on a professional killer, who could follow orders to the letter, without guilt or remorse

 **Medical History:** In the Red Room, she has suffered from multiple broken bones, pulled muscles, and horrible living conditions. When she graduated from the program, she went through a ceremony that made her infertile. On SHIELD missions she has sustained many minor injuries, including being captured and beaten by Ultron.

 _Family and Social History:_

Natalia's parents are unknown, and she was raised in the Red Room. At the Red Room, Natalia was instructed by Madame B. In the Red Room, Natalia learned how to fight to the death. As a hired killer, she was trained to shut down emotions through routine drills and punishments. There she learned English and Western Culture, and she became friends with some girls at the Red Room. However when she became of age, she graduated from the program, where she was sterilized. During a mission, Natalia was discovered by Barton. She was taken to the Barton's home, where she recovered and agreed to train her. She became a SHIELD agent, and Agent Barton's partner. When Avengers was created, she joined and assisted several missions. She had a romantic relationship with Bruce Banner, but they have not spoken since the battle of Sokovia.

 _Summary of Previous Evaluations:_

Natalia underwent multiple psychiatric evaluations while in training during the Red Room. However, the purpose of these evaluations was to maintain her mental stability during a mission, and not to bolster her emotional health. As such, they are useful in tracking her progress only as comparison to intelligence and adaptability, not to her psychological health. Once she came to SHIELD, she was reexamine and assessing her intelligence, personality, behavior, and coping strategies.

 **Behavior Observations  
**  
 _Testing Behavior  
_  
Natasha is a short tempered woman in the prime of life. She took part of all tests begrudgingly, indicating that it was an order. Throughout the interview, she was evasive about many of her emotions, saying they destruct her from a mission. If a subject, such as the Red Room, her partnership with Agent Barton, or her romantic feelings for Bruce Banner were brought up, she stated the topic was classified, and remained silent. Only after reporting to Nick Fury of her uncooperativeness, did Agent Romanoff allow herself to show any emotion. She mainly expressed concern for a few team members safety, and claimed little regret of any actions she ever committed.

 _Psychological Assessment  
_  
The clinical interviews for Natalia took place over two days. On the first day, the Assessment of Intellectual Functioning (IQ) and the clinical interview took place. A week later, she returned and the Personality Assessment and the Behavioral Assessment took place. After the test were complete, the client was debriefed.

TESTS ADMINISTERED

Standardized assessment targeted the domains of intelligence, learning processes, academic achievement and emotional/psychological development.

STANDARDIZED INSTRUMENTS:  
Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV)  
Cognitive Assessment System  
Wechsler Individual Achievement Test  
Myers Briggs Personality Assessment

Diagnostic Checklist for Paranoid Personality Disorder

INFORMATION ASSESSMENT TECHNIQUES:  
Development History Form  
Interviews  
Primary Sources Inventory

Behavior Observations  
Review of SHIELD mission reports

Review of medical reports

 **RESULTS FROM TESTING**

Using information from multiple sources, the following domains of functioning were analyzed in terms of the effect the on Natasha's cognizant and emotional assessment.

 _Assessment of Intellectual Functioning (IQ):_ The IQ was scored using WAIS-IV with the four index scores Verbal Comprehension, Perceptual Reasoning, Working Memory, and Processing Speed. The combination of the scores was used to determine her intelligence functioning score at 134, placing her in the very superior intelligence category.

 _Personality Assessment._ Based on the Myers-Briggs personality test, Natasha fits into the ISTP, or "virtuoso" personality. This personality can be described as private, practical, logical, flexible, and project-oriented. On the positive side, Natasha displays creativeness, quick thinking, spontaneity, and easy going nature. However, she can often be stubborn, insensitivity, unnecessarily risky, private, and difficult to date.

 _Clinical Interview._ The clinical interview was a face to face interview conducted in the office. Results indicated that Natasha is a very reserved woman, but she also is passionate. She cares deeply for the members of the Avengers, particular Hawkeye, Hulk, Captain America, Iron Man, and Thor, referring to all of them as "her boys". Also, she is very close to members of Hawkey's family, and to select personnel at STARK INDUSTRIES, including Virginia Potts and Happy Hogan.

Natasha experienced a traumatic upbringing in the Red Room. She was trained to be ruthless, and not have a sense of morality. She developed morality as an adult, using interpersonal conformity, stage 3 in Eisenburg's moral development, living up to her role as a high-clearance SHEILD agent. This is demonstrated when the client refers to her past actions, committed in service to the KGB, as having "red on her ledger".

 _Clinical Diagnosis:_ Paranoid Personality Disorder

Diagnostic Criteria met for Paranoid Personality Disorder can be diagnosed by meeting four or more of seven criteria. Natasha meets the following four (4):

Constantly suspects that people are deceiving her

Reluctant to confide in others based on unwarranted fear that the information could be used against her

Persistently bears grudges

Perceives attacks on his or her character or reputation that are not apparent to others, and is quick to react angrily or to counterattack 

**SUMMARY**

Natasha is a 32 year old Russian female who was referred for neuropsychological assessment to determine her mental and emotional status and to make recommendations regarding a treatment plan. She has experienced a painful upbringing that resulted in developing Paranoid Personality Disorder. An evaluation of her early development, cognitive capability, emotional status and mental status resulted in a determination of a complex set of characteristics that are contribution to her difficulties.

Natasha performed at a very superior range of cognitive functioning with notable distinction in verbal functions. Excellent abstract cognitive capability was noted for abstract thinking in both verbal and nonverbal visual spatial modalities. These good capabilities are reflected by her outstanding ability to survey situations and eliminate targets. Her oral language is also mature, demonstrated by her multi-lingual communication skills. Her academic skills are all within the average or above level.

She demonstrates some positive symptoms of Paranoid Personality Disorder. Most likely the underlying cause is her upbringing in Soviet program Black Widow which valued manipulation and ruthlessness to cultivate an assassin's lifestyle. Training focused on suppressing emotions to accomplish any mission. Any treatment must address her developmental abuse.

Treatment

In order to best serve Natasha's needs, there is a major area that will be targeted for effective intervention.

Psychotherapy. Therapy will only be useful if a level of trust is developed and maintained with the client.

This will be developed by the client agreeing to a bi-weekly sessions with the knowledge, that she can refuses sessions at any time. However, any refusal will be reflected in her file and may impact mission assignments.

The purpose of these sessions will be to examine which aspects of the client's life is causing and eliminating paranoid thought process.

At this time medication is not recommended.

 _References_

ADour. (2012, September 20). Natasha Romanoff (Earth-199999). Retrieved August 13, 2017, from  wiki/Natasha_Romanoff_(Earth-199999)

FANDOM Movies Community. (2010, November 2). Black Widow. Retrieved August 13, 2017, from  wiki/Black_Widow

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